Connecting governance culture and hospital performance improvement

A freely downloadable ‘trustee workbook’ from the American Hospital Association’s Centre for Healthcare Governance encourages hospital boards to examine board culture and the board’s capacity to sustain a comprehensive hospital performance improvement programme.

The workbook suggests that boards review the following questions to understand their role and analyse their capability as a leader of performance improvement. The workbook further suggests that the board could also use these questions as a guide for discussing the organization’s performance improvement program.

1. Is your board enthusiastic about its own self-assessment process? Are board goals or an action plan for improvement developed based on the board’s performance evaluation survey?
2. Does your board have a formal process to evaluate the CEO’s performance in meeting predetermined goals? Do board members talk to the CEO about the evaluation in detail?
3. Does the board review and discuss a comprehensive, organized set of data, such as a scorecard or dashboard, to measure organizational performance improvement?
4. Is there a systematic board education process, including periodic retreats, with a focus on global health care trends and strategic issues? How does the board monitor and measure each trustee’s ongoing participation in board education?
5. Is the board’s work aligned with that of the CEO, its corporate structure, physicians and the community served? Do internal politics have a negative impact on the board’s tenor?
6. Does the board use its systematic performance monitoring mechanism-such as scorecards-and its education on global issues to develop a strategic position for the hospital?
7. Has the board analyzed the health care organization’s motivations for supporting performance improvement? Are there sustainable, intrinsic reasons to improve? Are the hospital’s public image, external requirements or financial concerns major drivers?